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Symptoms–White Pustules

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Can psoriasis cause white pustules?

White pustules are symptoms of a rare form of psoriasis called pustular psoriasis. Unlike plaque psoriasis, which causes patches of raised, inflamed, scaly skin to develop, pustular psoriasis causes the development of small white blisters (pustules)1. Like plaque psoriasis, pustular psoriasis is a chronic autoimmune condition that is life-long, although symptoms may flare up and then go away in cycles over time.

Pustules appear on areas of skin that first becomes dry, red, and sore to touch. The blisters are filled with pus, a clear liquid filled with white blood cells. The pustules will usually spread into each other over the next day to form larger areas of pus, which then dry out and peel off, leaving an area of smooth skin where pustules can appear again2.

The pustules are not infected and they are not contagious to other people. The pustules can appear anywhere on the body, but they most commonly develop on the hands and feet. Pustules can appear all over the body (generalized pustular psoriasis) or just in certain areas (localized pustular psoriasis)2.

How common are white pustules among people with psoriasis?

Pustular psoriasis is quite rare, affecting less than 2% of people with psoriasis in the United States. It is more common among adults than children and affects men and women at roughly equal rates2.

What causes white pustules to develop?

Researchers have found that there are many possible triggers that can cause a person to develop pustular psoriasis and white pustules3. These include:

Some of the medications that are known to trigger the development of white pustules in some people include4:

Aspirin

Lithium

Iodine

Some beta blockers

Indomethacin

Calcipotriol

How are white pustules treated?

Pustular psoriasis is a serious condition that can require powerful types of treatment to be effective. It is important to seek treatment right away for pustular psoriasis because it can cause very serious complications3:

Headache

Fever and/or chills

Increased heart rate

Weakness

Nausea and/or loss of appetite

Most patients with the condition will need a combination of different treatments, such as

Depending on the severity of the condition, some patients may need to have treatment in the hospital to make sure that they do not become dehydrated or experience other types of serious side effects4.

Treatments at home to make the patient more comfortable may include compresses applied to the affected area, or taking baths with salts or colloidal oatmeal added. Be sure not to scrub or wash too vigorously, because it can further irritate the skin5.

As with any type of psoriasis, patients should try to identify the triggers that cause them to have flare ups of white pustules. Avoiding these triggers can increase the amount of time between flares.

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1. National Psoriasis Foundation. About Psoriasis. Available at https://www.psoriasis.org/about-psoriasis
2. Cleveland Clinic. Psoriasis. Available at http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/psoriasis-papulosquamous-skin-disease/
3. National Psoriasis Foundation. Pustular Psoriasis. Available at https://www.psoriasis.org/about-psoriasis/types/pustular
4. University of Maryland Medical Center. Psoriasis. Available at http://umm.edu/health/medical/reports/articles/psoriasis
Annie O Morrison, MD. Overview of Pustular Psoriasis. Available at http://emedicine.medscape.com/article/1108220-overview#a1